AB1166 RANDOMIZED CONTROLLED TRIAL TO ANALYSE THE EFFECT OF BLOOD FLOW RESTRICTION TRAINING IN RHEUMATOID ARTHRITIS AND PSORIATIC ARTHRITIS COMPARED TO CONVENTIONAL RESISTANCE TRAINING – AN INTERIM ANALYSIS
Authors: C. J. Bauer, M. Sturhahn, C. Behning, S. Petzinna, P. Brossart, P. Preuss, V. Schäfer
Journal: Annals of the Rheumatic Diseases (2023)

<h3>Background</h3> Rheumatoid arthritis (RA) and psoriatic arthritis (PsA) are the two most common forms of arthritis with a prevalence of 1% and 0.5% in Europe. Physical activity exerts a major influence on disease activity, symptoms, quality of life, and increased cardiovascular risk [1,2]. In contrast to conventional strength training, Kaatsu blood flow restriction (BFR) training, which was initially developed in Japan as a rehabilitation measure, incorporates pneumatic cuffs applied to the extremities, which are recurrently inflated with a defined pressure. The inherent blood flow modification promises a less weight-intensive and thus joint-protective strength training, while still preserving sufficient muscular hypertrophy stimulus [3]. <h3>Objectives</h3> Ours is the first study in the world to compare the effect of Kaatsu blood flow restriction training to conventional resistance training in RA and PsA patients. <h3>Methods</h3> In this pilot study (ethical approval under Institutional Review Board #217/20), 40 RA and 40 PsA patients are individually randomized to one of three groups: Kaatsu-BFR training (20 patients each), conventional resistance training "CRT" (10 patients each), or the non-exercise group (10 patients each). Training is performed twice weekly over a 12-week period. Standardized recording of disease activity (via FFB-H-P, IPAQ, and DAS 28 or PSAID12, plus clinical examination and CRP), myokine levels, sonographic muscle diameter measurements, bioimpedance analysis and clinical characteristics is performed. <h3>Results</h3> The interim analysis of 9 BFR vs. 4 CRT patients with rheumatoid arthritis showed comparable CRP reduction (mean ± SD: BFR: -1.08 mg/L ± 1.33, CRT: -0.89 mg/L ± 1.94) and reduction in the number of painful joints (mean ± SD: BFR: -0.78 ± 2.44, CRT: -0.76 ± 1.71) during the training period. BFR group results surpassed CRT group results in terms of weight loss (mean ± SD: BFR: -2.9 kg ± 3.6, CRT: -1.9 kg ± 3.1) and body fat mass reduction (mean ± SD: BFR: -2.8 kg ± 5.3, CRT: -0.3 kg ± 2.5). The interim analysis of 4 BFR vs. 4 CRT patients with psoriatic arthritis showed a comparable PSAID reduction (mean ± SD: BFR: -5.1 ± 12.1), CRT: -4.3 ± 9.0) during the training period. BFR group results exceeded CRT group results with regards to CRP reduction (mean ± SD: BFR: -0.15 mg/L ±0.91, CRT: 1.27 mg/L ±2.7), weight loss (mean ± SD: BFR: -2.4 kg ±1.7, CRT: +1.3 kg ±0.7) and body fat mass reduction (mean ± SD: BFR: -2.5 kg ±1.2, CRT: +0.6 kg ±1.0). <h3>Conclusion</h3> These results provide preliminary evidence that 12-week Kaatsu blood flow restriction training exerts a positive effect on disease activity parameters in patients with arthritis. Furthermore, BFR training shows comparable, in parts even more favourable results than CRT, suggesting it as an effective alternative to conventional strength training. Completion of the study data set is expected in March 2023. <h3>References</h3> [1]Katz P, Andonian BJ, Huffman KM. Benefits and promotion of physical activity in rheumatoid arthritis. <i>Current opinion in rheumatology</i> 2020;<b>32</b>:307–14. [2]Kessler J, Chouk M, Ruban T, <i>et al.</i> Psoriatic arthritis and physical activity: a systematic review. <i>Clinical Rheumatology</i> 2021;<b>40</b>:4379–89. doi:10.1007/s10067-021-05739-y [3]Loenneke JP, Wilson JM, Marín PJ, <i>et al.</i> Low intensity blood flow restriction training: a meta-analysis. <i>Eur J Appl Physiol</i> 2012;<b>112</b>:1849–59. doi:10.1007/s00421-011-2167-x <h3>Acknowledgements:</h3> NIL. <h3>Disclosure of Interests</h3> None Declared.